Healthcare Provider Details

I. General information

NPI: 1972910339
Provider Name (Legal Business Name): GRIFFEN TAYLOR ALLAN GEORGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7444 HANNOVER PKWY S STE 210
STOCKBRIDGE GA
30281-7847
US

IV. Provider business mailing address

410 W 10TH AVE
COLUMBUS OH
43210-1240
US

V. Phone/Fax

Practice location:
  • Phone: 882-220-6432
  • Fax:
Mailing address:
  • Phone: 614-366-5405
  • Fax: 614-293-4556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number82557
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: